title: Anterior thoracolumbar reconstruction surgery for late collapse following vertebroplasty: report of three cases.
abstract: Although vertebroplasty (VP) using polymethylmethacrylate (PMMA) is thought to be an effective procedure for osteoporotic vertebral compression fractures, several complications have been reported. In this paper, we present three patients who developed local kyphotic deformity as a result of late collapse of the cemented vertebrae. In all patients we safely removed the PMMA block through an anterior approach and anterior reconstruction was performed successfully. In only one patient who had a three column unstable injury with fractured posterior elements was additional posterior spinal fixation needed. In conclusion, VP is thought to be an effective and minimal invasive technique to treat osteoporotic compression fractures in older patients. Once collapse or nonunion of the treated vertebral body occurs, however, removal of the cement and anterior reconstruction may be required to realign of the affected segments and reconstruct the spine.
authors.affiliation: Department of Orthopedic Surgery, Tokushima Municipal Hospital, Tokushima, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyagi
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.forename: Nitin N
authors.initials: NN
authors.lastname: Bhatia
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Katoh
authors.forename: Takashi
authors.initials: T
authors.lastname: Chikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects; D019299:Decompression, Surgical / Q000009:adverse effects; D005260:Female; D050815:Fractures, Compression / Q000601:surgery*; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D012086:Reoperation; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D054854:Vertebroplasty / Q000009:adverse effects*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate